The main mandate of nurses is to secure the health and general wellbeing of their patients. While most nurses strive to execute this mandate, there are numeorus hurdles that they encounter. Poor and dangerous practices are among these hurdles. When the environment in which a nurse works compromises the welfare of nurses, patients and other parties, it becomes very difficult for nurses to perform their duties. It is the duty of a nurse to speak up when they observe dangerous, illegal or unethical practices being committed (Mansbach et al., 2014). This is the essence of whistleblowing. Thanks to whistleblowing, nurses are able to expose illegalities and unethical conduct that endanger patients. As they report these practices, nurses should understand that they will suffer. Whistleblowing carries a very high cost that nurses must be willing to incur.
Significance
Whistleblowing is an important issue for nursing. One significant role that it plays is that it allows nurse leaders and managers to understand safety and quality concerns (Schein, 2016). Whistleblowing occurs when one observes that there are certain realities that are dangerous and have been left unaddressed. Thanks to whistleblowing, nurse leaders are able respond to the concerns that their juniors raise. Another important role that whistleblowing plays for nurse leadership is that it challenges leaders to open up communication channels (Schein, 2016). To understand this function, it is necessary to consider a scenario. Suppose that there lacks effective communication in a health facility. This makes it difficult for the leaders at the facility to understand the experiences of nurses and patients. The lack of communication may prompt a nurse who feels frustrated owing to the lack of action from the leadership to blow the whistle. In this example, whistleblowing may inspire the leaders to do more to create better communication channels and strategies.
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Challenging nurse leaders to take action to address the concerns that whistleblowers raise is another significant role that whistleblowing plays (Jones, 2015). As noted earlier, whistleblowing is a tool that nurses can use to shed light on practices and issues that pose a threat. Most cases of whistleblowing occur when nurses have tried to raise the alarm but no action has been taken. When an incident of whistleblowing occurs, it is essentially a message to the leadership to take action. Overall, whistleblowing allows leaders and managers to become more responsive to the needs and concerns of nurses.
Literature review
Whistleblowing is intended to allow nurses to speak up. However, when not done properly, it can have disastrous consequences. It is therefore vital for nurses to follow best practices that have been developed to govern whistleblowing (Philipsen & Soeken, 2011). Exhausting other alternatives before resorting to whistleblowing is one of the best practices. When a nurse notices a dangerous, unethical or illegal practice, they should employ internal mechanisms to get the issue addressed. For example, the nurse may report the matter to the immediate supervisor. It is only when the internal mechanisms have proven effective and the leaders have demonstrated no willingness to address the issue that the concerned nurse should proceed to blow the whistle.
Acting in good faith is another best practice that nurses who wish to blow the whistle should embrace (Blickenstaff & Lanier, 2012). Nurses should ensure that the reports that they make are accurate and reflect the true situation at their facility. They should avoid making false reports that stem from a petty dislike of the leaders or some other personal issue. The concerns that they raise should be concrete, credible and substantial. This will provide them with legal protections. When a nurse makes a false report, they lose the protection of the law. The nurse’s employer may choose to terminate their employment and the nurse would lack legal recourse. Therefore, as they blow the whistle, nurses should remain professional and raise concerns about actual issues that hinder the effective delivery of quality healthcare to patients.
A note has been made of the damage that a health facility can suffer when a whistleblowing incident occurs. When the facility responds by firing the nurse who has shed light on misconduct, the facility suffers further damage. It is vital for health facilities to create environments where nurses feel comfortable to raise concerns (Jackson et al., 2009). This is another best practice that nurses and healthcare providers need to integrate into their operations. The providers need to guarantee nurses that they will not face such risks as losing their jobs when they decide to blow the whistle. This will encourage the nurses to speak out. It will also enhance trust and allow the healthcare facility to promptly respond to the issues that the nurses raise. Furthermore, an environment that encourages nurses to speak out protects relationships among colleagues (Jackson et al., 2009). When a nurse blows the whistle in such an environment, they are assured that their relationship with colleagues will remain cordial.
Whistleblowing presents impacts for nurse leaders. One of the effects is that it challenges the leader to take action. Whistleblowing is essentially a call for action. It is a reminder to leaders that there are certain shortcomings that must be addressed urgently. How the nurse leaders respond to this call offers insights into their leadership. A leader who listens and responds demonstrates effective leadership. On the other hand, a nurse leader who takes disciplinary action against the whistleblower is vindictive and lacks the traits that nurse leaders need to possess. Whistleblowing also offer nurse leaders the opportunity to establish better communication channels. As already noted, some cases of whistleblowing occur as a result of the lack of proper upward communication avenues. A nurse leader can respond to whistleblowing through the creation of effective communication channels that allow lower-ranking nurses to report and raise concerns.
It is true that whistleblowing presents numerous opportunities that nurse leaders can exploit to improve service delivery. However, whistleblowing also presents negative implications for the nurse leader. Whistleblowing is essentially an indictment that paints the nurse leader in negative light. It points to a lack of effective leadership. It also indicates that the internal mechanisms in place are unable to address the issues that the whistleblower raises. It is little wonder that many nurse leaders discourage whistleblowing. Even nurses tend to shy away from whistleblowing (Habermann et al., 2010). Whistleblowing is associated with trouble making. Despite the fact that whistleblowing highlights the failure of leadership, it remains an opportunity for nurse leaders to correct mistakes.
Application
Ethical conduct is one of the applications of whistleblowing (Grant, 2010). Healthcare providers are required to act ethically. When they fail to do this, they compel conscientious nurses to blow the whistle. Whistleblowing challenges nurse leaders to return to the path of ethical operations. Another application of whistleblowing is that it promotes constant monitoring of operations to ensure that they are in line with best practices and standards. For example, when a nurse leader fears whistleblowing, they will take all necessary steps to ensure that the operations of their facility are in full compliance with standards and regulations.
Whistleblowing also presents implications and consequences for the nurse leader. Among the implications of whistleblowing is the question of confidentiality (Firtko & Jackson, 2005). Nurses have an obligation to accord their patients and their practice utmost confidentiality. When they blow the whistle, they breach this confidentiality. The mandate of the nurse leader is to determine the proper balance between the need to report misconduct and to uphold such ethical principles as confidentiality. Whistleblowing forces the nurse leader to choose between tolerating violations of confidentiality or taking action against whistleblowers.
One of the purposes that whistleblowing seeks to serve is to safeguard the rights and wellbeing of patients. For example, a nurse may raise the alarm when they feel that patients are being overcharged for a service or the facility is engaging in some other form of misconduct. The problem with whistleblowing is that it places the nurse leader in an awkward situation (Firtko & Jackson, 2005). On the one hand, the nurse leader needs to protect the reputation of the facility. On the other hand, they have an obligation to protect the patients. Unless the nurse leader handles whistleblowing delicately, they may be unable to achieve any of the conflicting mandates. It is vital for the nurse leader to create an environment and develop mechanisms that allow for the rights of patients to be safeguarded without posing a risk to the reputation of the facility.
Healthcare providers rely on profits to deliver care to patients. This tempts the providers to go extreme lengths to maximize profits. For example, in an effort to generate as much revenue as possible, a provider may offer patients unnecessary services or overcharge the patients for services. Such practices challenge nurses who care about their patients to speak out. Whistleblowing basically reminds nurse leaders of the need to develop patient centered approaches instead of placing too much focus on profits (Rolland, 2008). An incident of whistleblowing is a wakeup call to the nurse leader to return to the true purpose of nursing: patient-focused service delivery.
If you see something, say something. This is what whistleblowing entails. It challenges nurses to speak out against misconduct and illegalities. As they do this, nurses safeguard the wellbeing of their patients and the integrity of the nursing profession. However, whistleblowing places nurses at the risk of retaliatory action. Their employer may choose to fire them. Despite this risk, nurses should remain committed to patients and the profession. Nurse leaders should also encourage nurses to raise the alarm. They should also create an environment where whistleblowers feel secure. These initiatives will go a long way in ensuring that all members of the nursing profession act responsibly.
References
Blickenstaff, K. M. (2012). Whistleblowing- How to Ensure that the Law Protects You. Ohio Nurse, 6 (1). Retrieved 30 th November 2017 from
http://nursingald.com/uploads/publication/pdf/125/OH12_12.pdf
Firtko, A. & Jackson, D. (2005). Do the Ends Justify the Means? Nursing and the Dilemma of Whistleblowing. Australian Journal of Advanced Nursing, 23 (1), 51-56.
Grant, P. (2010). Ethical Lessons from the ‘Undercover Nurse’: Implications for Practice and Leadership. Journal of Medical Ethics, 36 (8), 469-472.
Habermann, M., Cramer, H., Pielage, F. & Stagge, M. (2010). Whistleblowing: A Difficult Concept for Nurses. Pflege, 23 (5), 321-329.
Jackson, D., Peters, K., Andrew, S., Edenborough, M., Halcomb, E., Luck, L., Salamonson, Y. Weaver, R. & Wilkes, L. (2009). Trial and Retribution: A Qualitative Study of Whistleblowing and Workplace Relationships in Nursing. Contemporary Nurse, 36 (1-2), 34-44.
Jones, A. (2015). The Role of Employee Whistleblowing and Raising Concerns in an Organizational Learning Culture-Elusive and Laudable? International Journal of Health Policy And Management, 5 (1), 67-69.
Mansbach, A., Kushnir, T., Ziedenberg, H. & Bachner, Y. G. (2014). Reporting Misconduct of A Coworker to Protect a Patient: A Comparison between Experienced Nurses and Nursing Students. The Scientific World Journal. DOI: http://dx.doi.org/10.1155/2014/413926
Philipsen, N. C. & Soeken, D. (2011). Preparing to Blow the Whistle: A Survival Guide for Nurses. Retrieved 30 th November 2017 from https://whistleblowing.us/2011/10/preparing-to-blow-the-whistle-a-survival-guide-for-nurses/
Rolland, P. (2008). Whistle Blowing in Healthcare: An Organizational Failure in Ethics and Leadership. The Internet Journal of Law, Healthcare and Ethics, 6 (1), 1-12.
Schein, E. H. (2016). Whistle Blowing: A Message to Leaders and Managers. International Journal of Health Policy and Management, 5 (4), 265-266.
